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Knowledge, Attitude and Practices (KAP) of Oral Hygiene among School Children

Article  in  Pakistan Journal of Medical and Health Sciences · April 2022

DOI: 10.53350/pjmhs22164503

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 DOI: https://doi.org/10.53350/pjmhs22164503
ORIGINAL ARTICLE

Knowledge, Attitude and Practices (KAP) of Oral Hygiene among School

Children
TAYYABA ZIA1, ALOK DUBEY2, TANIA NAVEEL3, SYMA ARSHAD4, MOHAMED GAMAL ELSEHRAWY5, SAJAD AHMAD6
1
Phd Scholar, Public Management School of Humanities and Law, Yanshan University, Qinhuangdao, Hebei 066004, China
2
Associate professor, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
3
Department of Pharmacology, Jinnah University for Women, Pakistan
4
Assistant professor, Rashid Latif medical college, Lahore, 54000-Pakistan
5
Assistant professor of Nursing, Applied Medical Sciences College, Prince Sattam Bin Abdulaziz University, Kingdom of Saudi Arabia
6
Health Education Officer, Regional Blood Center, Dera Ismail Khan, KPK, Pakistan
Corresponding author: Mohamed Gamal Elsehrawy, Email: [email protected]

ABSTRACT
Poor oral health can have a profound effect on the quality of life. Pain, tooth abscess endurance, eating and chewing difficulty,
embarrassment over the form of teeth or missing, discolored, or broken teeth can all have a negative impact on people's
everyday life and well-being. In the current study majority of respondents practised appropriate oral hygiene habits such as
brushing twice a day using a toothbrush and toothpaste for 2 to 3 minutes. Almost 88 percent were aware of the unhealthy
gingival condition and the effects of plaque formation. Approximately 53.14 percent were aware of gum illnesses, and 50.14
percent believed that gum diseases might be avoided if proper oral hygiene practices were followed. Nearly half of the
youngsters (52.1 percent) said they would only go to the dentist if they were in pain, despite the fact that the majority (79.4
percent) said regular dental checkups were vital. Fear was stated as the primary reason for not attending the dentist (67.28
percent). The study concluded that the most frequent oral hygiene device used for cleaning teeth is a toothbrush with
toothpaste; it was discovered that a larger proportion of students cleansed their teeth in the morning. The primary reason for
seeing a dentist was for dental discomfort. Further studies related to knowledge, attitude and practice (KAP) of the students
about oral health can be encouraged.
Keywords: Oral health; knowledge; Attitude; Practice; Questionnaire; Students

INTRODUCTION the questions mentioned in the questionnaire. Male students of 12-

Most civilizations have a strong emphasis on health. Over the last 16 years old were included or interviewee in this study.
several decades, there has been a reawakening to the concept Data analysis: Means, standard deviation and frequency
that health is a fundamental human right and a global social aim distribution were calculated by using descriptive statistics. Data
that is crucial to meeting basic human requirements and improving were statistically analyzed using the Statistical Package for Social
one's quality of life. For all cultural groupings, health is a universal Science (SPSS) 11.0.
requirement. Without good dental health, it is impossible to achieve
or sustain good overall health. Because of their great frequency RESULTS
and severe socioeconomic effect, oral illnesses are classified as 27.90%, 52.90%, 12.18% and 7.00% students used miswak,
serious public health issues. (Kay and Locker, 1997; Navneet and toothbrush and paste, dental floss and toothpicks, respectively.
Manpreet, 2007). 13.63% parents supervised their children while 81.09% not.
Oral health is described as "a level of health of the mouth 39.63% participants responded that they brushed their teeth three
and associated tissues that enables an individual to eat, speak, times in a day while only 1.72% brushed several times (Table 1).
and socialize without active illness, discomfort, or embarrassment
and adds to overall well-being." This new viewpoint on health Table 1: Response of participants regarding oral health practices.
recommended that the ultimate aim of dental treatment, namely Practice Response Number of Percentage
excellent oral health, should no longer be viewed just as the participants (%age)
absence of caries or periodontal disease; a patient's emotional and Miswak 307 27.90
Primary tooth cleaning Toothpicks 77 7.00
social well-being should also be addressed (Gopikrishna et al., aid Toothbrush 582 52.90
2016). and paste
Based on this, the major focus of dental practitioners and Dental floss 134 12.18
oral health educators is to instill oral health awareness and Yes 150 13.63
practice in society. There has been a developing concept of health Parents supervision No 892 81.09
promotion via education, teaching, and motivation all over the during brushing Not aware 58 5.27
world that fosters an atmosphere suitable to moving the burden of One time 260 23.63
public health from the shoulders of health care professionals to Two time 366 33.27
'people's own hands.' To do so, precise knowledge and Frequency of brushing Three time 436 39.63
comprehension of scientifically evident information and facts are teeth Several time 19 1.72
required. Rarely 23 2.09

MATERIAL AND METHOD It was observed that 46.27% participants used floss and
paste both keeping the gums healthy while 21.00, 12.18 and
A descriptive cross-sectional survey was conducted during 25
8.81% participants used tooth brush, dental floss and mouth wash,
April-25 March 2019. The study area was divided into five parts:
respectively. 61.00% participants responded that soft drinks effect
Southern, Northern, Central and Eastern. Two colleges were
the dental health and dental decay caused due to use of excess
randomly selected from each part. The sampling frame was
sugary diet as responded by 65.36% participants as given in table
consisted of 1100 nursing students of eight different colleges
2.
situated in city Multan with an enrollment of 3000 nursing students.
Majority of participants responded that they visit dentists on
Data were collected randomly by using random sampling
the dental pain (54.54%) and dentists advise (14.54%). More than
technique. A questionnaire was made containing different
27% participants did not visit dentists due to fear of high cost while
questions about oral health and dentistry which asked from 1100
45.45% due to fear of needle (Table 3).
students. The interview was taken for half an hour (30 min.) to ask

P J M H S Vol. 16, No. 04, APR 2022 503

Knowledge, Attitude and Practices (KAP) of Oral Hygiene among School Children

Table 2: Gingival and periodontal health knowledge among the research 700
population Number of participants Percentage (%age)
Knowledge Response Number of Percentage 600
participants (%age)

Percentage (%age)
Tooth brush 231 21.00 500
Mouth wash 97 8.81 400
Keeping gums healthy Dental floss 134 12.18
Floss and 509 46.27 300
paste
Unawareness 129 11.72 200
Yes 671 61.00 100
Soft drink’s effect on No 200 18.18
dental health Don’t know 229 20.81 0
Yes 719 65.36 Soft food Vitamins Brushing and Don’t know
Dental decay occurs due No 189 17.18 flossing
to sugary diet Don’t know 192 17.45 Ways/Methods to prevent gum diseases
Illness 201 18.27
Gum bleeding indicates Gum disease 665 60.45 Figure 2: Ways/Methods to prevent gum diseases
Don’t know 234 21.27
Yes 912 DISCUSSION
Dental and mouth health No 85
Dental caries is the most prevalent chronic dental illness, affecting
effect the body health Don’t know 103
Yes 987 89.72
a large number of children and adolescents globally. The similar
Brushing teeth prevent No 97 8.81 results have been reported by many other researchers in the world
dental decay Don’t know 16 1.45 (Kassebaum et al., 2017). It was observed that mostly studies
population visited dentists during dental pain and dental advise
Table 3: Attitude of the studied population toward Professional Dental Care while many other scientists investigated the similar findings. Pain is
Attitude Response Number of Percentage the primary motivator for people to attend the dentist. Al-Omiri et
participants (%age) al., (2006) had reported the similar findings about toothache in
During pain 900 81.81 patients. It has also reported that 57.14% studied population were
Visit to dentist for Once a year 50 4.54 highly aware about gum diseases. They responded that persons
professional care Twice a year 60 5.45 can remain safe and sound while keeping oral hygiene practices.
Never 90 8.18 The participants were not visited dentists on regular basis and they
Dental 600 54.54 visit only when they feel pain in their teeth.
pain/Toothache
Reasons for visiting
A study was conducted by Togoo et al., (2012) in Saudi
Friend advice 142 12.90
the dentist General 88 8.00
Arabia 2012. They had reported the similar findings about gum
checkup diseases in school children. In the current study, it was observed
Dentist advice 160 14.54 that more than 60% participants aware about gum diseases while
Parents advice 110 10.00 21% people don’t know about gum diseases. In terms of manner of
Fear of high cost 297 27.00 cleaning teeth, tooth brushing was the most prevalent method
Fear of needle 500 45.45 employed by the research population, followed by miswak and
Reasons for not Fear of drill 123 11.18 dental floss. Dental floss was recorded the most least popular
visiting the dentist Shortage of time 67 6.09 approach or way to clean the teeth. Ronis and Lang (1993) had
No clinical 113 10.27 given the similar findings. In the study area, majority participants
facility relay on miswak. It is possible to recommend the best way to use
Yes 200 18.18
miswak as a cleaning procedure in order to get the most benefits.
Necessity to visit No 773 70.27
dental clinic regularly Don’t know 127 11.54
However, the advantages of utilizing a tooth brush and paste must
be emphasized. It was recorded that 39% participants cleaned
their teeth three times per day while many others researchers
investigated once in a day.
In developing countries people cleaned their teeth more than
three times in their homes, offices or hotels. Our findings are
identical to the findings of previous researchers (Kleemola-Kujala
and Rasanen, 1979; Al Tamimi and Peterson,1998). Furthermore,
only 81.09% of Saudi children were monitored by their parents
while brushing. This contradicts to prior research on Saudi parents'
attitudes about their children's oral health, which found that teeth
brushing was regarded as an essential technique for minimizing
dental caries. According to the study of Doshi et al (2007) 28% of
the participants brushed their teeth once daily in morning. The
morning become feasible for respondents to brush teeth to
become fresh while Al-Omiri et al (2006) suggested that 52% of
the respondents cleaned their teeth before going to bed.

CONCLUSION
The majority of participants had good understanding of oral health
Figure 1: Response of participants regarding plaque but lack of oral health behaviours. The findings of this study may
be useful in assessing the success of public education initiatives in
Response of participants regarding plaque and calculus is the future. The findings of this study also indicate that parents in
shown in figure 1. Maximum brushing and flossing methods were rural areas are less concerned about their children's oral health. As
tested by participants to prevent the gum diseases while soft food a result, parents' education must be incorporated in any
minimum as shown in figure 2. programme that promotes preventative oral care in schools, as

504 P J M H S Vol. 16, No. 04, APR 2022

 T. Zia, A. Dubey, T. Naveel et al

well as other oral health educational initiatives aimed at the 5. Ronis DL, Lang WP, Fraghaly MM, et al. Tooth brushing, flossing and
general public. Pain is the primary motivator for people to attend preventive dental visits by Detroit area residents in relation to
the dentist. As a result, more extensive research exploring in depth demographic and socio economic factors. J Public Health Dent 1993;
53(3): 138-45
on oral health knowledge, attitude, and practice may always be 6. Togoo, R. A., Yaseen, S. M., Zakirulla, M., Nasim, V. S., & Al
studied further. Zamzami, M. (2012). Oral hygiene knowledge and practices among
Conflict of interest: Authors declare no conflict of interest. school children in a rural area of southern Saudi Arabia. international
Acknowledgement: The authors would like to thank the Deanship journal of contemporary dentistry, 3(1).
of Scientific Research at Prince Sattam Bin Abdulaziz University, 7. Kassebaum NJ, Smith AGC, Bernabe E, et al. Global, regional, and
AlKharj, Saudia Arabia. national prevalence, incidence, and disability-adjusted life years for
oral conditions for 195 countries, 1990-2015: a systematic analysis
for the global burden of diseases, injuries, and risk factors. J Dent
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